For better or worse: Manufacturers roll out new technology

YARMOUTH, Maine - In the next five quarters, Invacare will roll out more new product than ever before. Sunrise Medical promises a similar barrage of technology. Smaller HME manufacturers are pushing technological envelopes in respiratory and rehab. But are these products better? Do the technological advances justify the roll-outs? And how does an HME provider know which mask to buy, or which concentrator, or which center-wheel drive power chair? These are some of the questions that HME providers are starting to ask with greater frequency. "If you're selling a walker, you may not need to look at a study to see how quickly you'll heal with this particular brand," said Joe Lewarski, director of the MED Group's National Respiratory Network. "But if we are talking about bi-level (CPAP), there ought to be clinical studies to distinguish one company's product from another." Products in the HME industry receive little independent scrutiny. The last meaningful look at oxygen concentrators by an objective third party occurred in a 1993 study conducted by ECRI, a non-profit health services research agency. Buyers of oxygen regulators have to go all the way back to 1976 for ECRI's look in that direction. More recently, the independent respiratory research firm, Valley Inspired Products, based in Savage, Minn., surveyed the industry's slate of oxygen conservers and published a study in the AARC journal Respiratory Care in 2000. That study found wide variations in the effectiveness of concentrators. "People used to assume that all oxygen conservers were the same," said Valley Inspired's Pete Bliss, "but they're not." As a way to break into the nasal CPAP passover humidifier market, Taga Medical designed a device that would best its competitors' humidity output, and then ran an internal study to support that. The results of the study were published last October in Respiratory Care, but because the researcher who conducted the study was a paid consultant, Taga hired McCoy and Bliss to validate the claims. "None of this would mean anything unless we had outside validation," said Geoff Sleeper, v.p. of research and development at Tiara Medical Systems, which distributes the Taga humidifier. Sleeper characterizes the Taga humidifier's reception as "excellent" and attributes some of that success to an independent study that validates its relative success. But Sleeper understands that in a fixed reimbursement system, being able to say you have the best product is by no means a guarantee of a product's success. "I used to own my own homecare company and when a sales guy would come into me and say, 'Well you know it's only a little bit more money, but it's a lot better,' I'd say, 'Get out of here,'" said Sleeper. "It better be as good or better and a little cheaper, which is precisely the criteria." Tiara had a stake in the outcome of Valley Inspired's validation of its product. If their test failed to mirror the company's own internal results, it's unlikely that Tiara would be reference the study as a marketing tool. Manufacturers are quick, perhaps quicker than providers, to acknowledge wide variations in performance. When Sunrise Medical's DeVilbiss division was testing its aerosol compressor, the company bought its competitors' machines and ran them through tests for six months. "The performances differences were amazing," said Rich Kocinski, a Sunrise Medical vice president. Like all manufacturers who fund internal studies, DeVilbiss is at liberty to disclose or not disclose the results of its study, which essentially leaves curious providers in the same boat. That's partly why Lewarski and the MED Group are starting to do product testing for one manufacturer, and would like to do more. "Part of what I am doing at MED is approaching companies to see if there are ways to help them develop products before final testing, so that they can do clinical trials, and objectively look at it, so those results can be published," he said. "That way, when a salesman comes to visit, you can look at more than a brochure." HME